Free State’s medicine supply in a state of ‘provincial emergency’

The researchers found that one in four public health facilities ran out of ARVs or TB medication over a three-month period in 2014.

The Free State health department has labelled a drug shortages report by the Stop Stock-Outs Project (SSP) as “opportunistic, mischievous and unscientific”.

Pressure group Stop Stock-Outs Project (SSP) found that the Free State’s medicine supply was in a state of “provincial emergency” after finding that all six facilities it surveyed between May and July in six sub districts experienced drug stock-outs of essential medicines.

The surveyed hospitals and clinics were located in Harrismith, Qwa Qwa, Bultfontein, Brandfort, Bloemfontein and Ficksburg. All of them reported stock-outs and shortages of common medicines such as antiretrovirals, tuberculosis drugs and paediatric medication. The facilities serve almost 4000 HIV infected patients.

The Treatment Action Campaign has accused the Free State health department of intimidation. Read it here.

But Free State health department spokesperson Mondli Mvambi told the Mail & Guardian that a “survey based on six facilities is by no means scientific and can’t be used to declare stock-outs across the province”.

“We’re not disputing the fact that there might be stock-outs at some clinics, but the timing of the SSP report is suspect. Health MEC Benny Malakoane announced a department turnaround strategy only last week … [and] re-allocations were done for all clinics and hospitals for compensation and goods and services … [making] finances available to institutions for use until the end of the financial year,” he said. “Let them give the MEC’s plan a chance to be implemented. How can things change overnight – give us at least a month,” he added.

Mvambi is also concerned about the “quality” of the SSP survey: “The people who carried out this survey are activists, driven by interests, and not qualified people such as medical officers or pharmacists,” he said.

But Lines said, SSP gave Free State health MEC Benny Malakoane a week to respond to the report, but his department has “remained silent”.

Mvambi responded: “SSP is not the custodian of health in this province, the MEC is. SSP is only a pressure group. They should allow the MEC to do his job.”

A previous SSP national survey, conducted in over a two month period in 2013, found that the Free State had the highest rates of stock-outs in the country with over half of the facilities surveyed reporting a lack of drugs. According to Lines, there was no response from the Free State health department to that report either.

“Our and the Treatment Action Campaign’s multiple attempts to engage the MEC constructively fell on deaf ears. The department seems bent on denying there is a problem with medicine supplies evidenced by the fact they haven’t taken any concrete steps to fix the situation,” she said.

In June 2014 social justice organisations Section27 and the Treatment Action Campaign reported stock-outs of over 200 essential medicines and supplies at the Free State provincial depot. In July the Free State health department was placed under the administration of the Provincial Treasury to deal with the non-payment of critical medicines and medical suppliers in the province.

“No patient should ever leave their clinic without the medicine they need…. [it puts] their lives at risk, [it puts them at risk of developing] preventable treatment resistance and death,” the report stated.

Lines said adherence to HIV and tuberculosis (TB) treatment in particular is “essential”.

“If patients don’t get their medication they are forced to default. This could contribute to the rising rates of multi-drug resistant TB which essentially places a greater burden on the health system in the long run,” she said.

“The fact that the health MEC refuses to acknowledge the problem shows a clear lack of accountability and poor leadership on his part. However, we will support any efforts to fix the health system in the province. To ensure history does not repeat itself going forward, we would like to see transparency from MEC Malakoane. We support calls for him to release a detailed plan and timelines on how they plan to fix the health system,” she added.